Individual
ADAM JACKSON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
619 S MARION AVE, LAKE CITY, FL 32025-5808
(386) 755-3016
(386) 754-7259
Mailing address
16505 NW 205TH ST, HIGH SPRINGS, FL 32643-8168
(386) 344-6543
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19968
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN19968
STATE LICENSE
FL
Enumeration date
07/08/2012
Last updated
10/07/2015
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